“When they start learning the field application of
medical skills in Block 2, some of these guys are thinking, ‘Holy mackerel, this is different medicine than I
learned in corps school,’” Miles said.

The basic care facility — the BAS — provides sick
call and general medical support for the unit while in
garrison, but takes on a different role when in the field.

“In combat, the mission of the BAS is to minimizethe effect wounds, injuries and diseases have on aunit’s effectiveness, readiness and morale,” Miles said.“The BAS does not have a patient-holding capability. Itis similar to a makeshift emergency room.”The training includes live role players, moulage kitsand a mass casualty exercise in the Combat CasualtySimulation Laboratory, with human patient simulationmannequins. The moulage kits are latex strap-ondevices that simulate a particular type wound, such aslaceration, gunshot, burn or compound fracture.Through these, the students learn how to conducttriage on the battlefield.

“A corpsman is presented with a casualty, and the
first thing he’s looking for is life-threatening hemorrhage, primarily from an arm or a leg. If he sees bright
red, spurting blood, he knows the immediate thing
he’s got to do is get a tourniquet on him because the
guy will bleed out in two minutes, or three minutes,”
Miles said.

The capstone three-day field exercise incorporates
tactics and medicine.

“They’re out there in defensive positions, on patrol
and conducting convoys,” Wright said.

“They establish a BAS, and casualties are moved into
the BAS, where they continue treating them,” Adams
said. “During their three-day exercise, we rotate the
four student platoons through our new combat simulation lab, with different rooms that have remote-control
mannequin simulators. They bleed, they breathe, they
moan, their eyes flutter and their chests move. The platoons go in and clear the building using tactics, then
treat the casualties.”

New Technology & Survival Rates

According to the July 2007 President’s Commission onCare for America’s Returning Wounded Warriors FinalReport, “In the Vietnam era, five out of every eight ( 62percent) seriously injured service members survived;today, seven out of eight (87 percent) survive, many withinjuries that in previous wars would have been fatal.”Much of that is due to evolving technologies andtechniques. Quick Clot Combat Gauze, for example,contains a hemostatic agent that stops arterial andvenous bleeding. New combat application tourniquetspermit self-treatment. If a Marine or Sailor has one func-tioning arm they can put the tourniquet on using Velcro,then twist or wind a plastic rod until the bleeding stops.

There were 2,500 Soldiers or Marines in Vietnam
who essentially bled to death, where, if they had used
an effective tourniquet, likely would have lived,
according to a study by Army Col. Ron Bellamy, a surgeon at Walter Reed Army Medical Center and an associate professor of military medicine and surgery at the
Uniformed Services University of the Health Sciences.
All of this is taught at FMTB.

Despite their new role, the students never lose their
Navy heritage. They study the Sailors’ creed and core
values, and they do not forget to celebrate the Hospital
Corps and Navy birthdays.

Units such as infantry battalions may have up to
two medical officers and 65 corpsmen to support 1,000
Marines. Other Marine Corps units may have a much
smaller complement of medical personnel. In combat,
the corpsman may be the only medical care for a seriously wounded Marine.

“Sailors are leaving here and going into groundcombat three months later,” Arellano said. “The differ-ence between a physician’s formal education and thatof the majority of young corpsmen is eight years. Yetwhen the injury occurs in combat, the first responderis a young corpsman the Marines call ‘Doc.’ So thestandard has to be high.”“Based on my three combat tours, the corpsmen inte-grated well with my unit, and did amazing, phenomenalthings in combat,” Wright said. “It all starts here.” ■